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Catheter-related infection and thrombosis of the internal jugular vein in hematologic-oncologic patients undergoing chemotherapy

A prospective comparison of silver-coated and uncoated catheters

  1. Christoph Harter1,†,*,
  2. Hans Jürgen Salwender Dr. med1,
  3. Alfons Bach Dr. med2,
  4. Gerlinde Egerer Dr. med1,
  5. Hartmut Goldschmidt Dr. med1,
  6. Anthony D. Ho Dr. med1

Article first published online: 28 DEC 2001

DOI: 10.1002/cncr.10199

Issue

Cancer

Cancer

Volume 94, Issue 1, pages 245–251, 1 January 2002

Additional Information

How to Cite

Harter, C., Salwender, H. J., Bach, A., Egerer, G., Goldschmidt, H. and Ho, A. D. (2002), Catheter-related infection and thrombosis of the internal jugular vein in hematologic-oncologic patients undergoing chemotherapy. Cancer, 94: 245–251. doi: 10.1002/cncr.10199

Author Information

  1. 1

    Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany

  2. 2

    Department of Anaesthesiology, University of Heidelberg, Heidelberg, Germany

  1. †

    Fax: 49-6221-565813

*Med. Klinik und Poliklinik V, Hospitalstrasse 3, 69115 Heidelberg, Germany

Publication History

  1. Issue published online: 28 DEC 2001
  2. Article first published online: 28 DEC 2001
  3. Manuscript Accepted: 13 SEP 2001
  4. Manuscript Revised: 9 AUG 2001
  5. Manuscript Received: 7 AUG 2001

Funded by

  • Fresenius AG, Germany
  • Metacot, Sweden

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Keywords:

  • central venous catheters;
  • silver-coated catheters;
  • catheter-related thrombosis;
  • hematologic-oncologic patients

Abstract

BACKGROUND

Catheter-related venous thrombosis is one of the most frequent complications of central venous catheters (CVCs). This complication occurs in 4– 40% of patients with hematologic malignancies receiving conventional chemotherapy after placement of CVCs.

METHODS

The objective of this prospective study was to assess whether a silver-coated CVC poses an additional risk in the development of catheter-related thrombosis in hematologic-oncologic patients. Patients were randomized to receive either silver-coated polyurethane catheters (BactiGuard; Metacot, Stockholm, Sweden) or uncoated standard polyurethane catheters (Cavatheter, Fresenius AG, Bad Homburg, Germany) for central venous access. Silver-coated catheters (n = 120) and standard catheters (n = 113) were inserted into the jugular vein in 233 consecutive patients. Variables that may be significant for the development of thrombosis were comparable in the two groups. After removal of the CVC, the patency of both jugularian veins internal as well as external was assessed with real-time ultrasound (Sonolayer-SAL-35A; Toshiba, Tokyo, Japan).

RESULTS

Four of 233 patients (1.5%) were found to have venous thrombosis. Incomplete occlusion of the internal jugular vein occurred in 2 patients (0.75%, parietal thrombosis), and complete thrombosis, although clinically silent, was found in 2 patients (0.75%). There was no difference between patients with silver-coated and uncoated CVCs.

CONCLUSIONS

The authors concluded that this novel silver-coated CVC does not cause a higher rate of central venous thrombosis compared with standard CVCs. The low overall incidence of central venous thrombosis might be attributed to the routine application of low-dose heparin in our patients during chemotherapeutic treatment. Cancer 2002;94:245–51. © 2002 American Cancer Society.

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